Best Mastopexy Technique for Tubular Breasts?

In general, I have found that the circumareolar technique with dual plane approach, radial relaxing incisions and submuscular placement of a high profile silicone gel filled implant to provide the best option for a tubular breast in my experience,

Thank you for the question.  
 
Some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" and areola and some degree of ptosis (drooping).  

Generally,  correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In the most severe cases of tuberous breast, a more complete breast lift may also be necessary.  In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
 
When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant experience with this type of surgery.

I hope this helps.
 

Without a formal exam it owuld be hard to tsay for sure, but in general a few things usually are required.1) to open the lower pole, 2)to reduce the areola and 3)sometimes to implode the breast tissue that herniates through the areola.  Sometimes a donut mastopexy with an implant can help.  If there is enough volume of tissue than several different techniques are available.

Tuberous (Snoopy Dog or Constricted) breasts share several characteristics in common; rather than a hemispheric shape they look like a plant tuber root crowned by a herniated , protruding instead of a flat areola. Before embarking on any other modifications (such as augmentation or lifting), the constricting bands along the waist of the breast need to be released. This is best done via an incision around the areola.

The same incision can then be used to remove some of the fat that pushes the areola up, for placing an implant and for a Breast Lift. The exact type of lift would depend on how much lifting is required; short lift - a periareolar lift may suffice but if a larger lift is required a short scar / lollipop scar may be needed.

The tuberous breast characteristically has a prominent nipple which mushrooms forward on the breast, and a kind of herniation of the the nipple areola as is pushes forward. The skin around the areola is generally constricted or tight, and the skin in the lower part of the breast is also tight. The correction involves augmentation of the base of the breast, and release of the constricted skin, with correction of the mushroomed out nipple. The scar line to expect is that of a circumareolar mastopexy, around the nipple, though keep in mind the correction is not a breast lift.
Best of luck,
peterejohnsonmd